GROSS DESCRIPTION:
Part 1 is labeled "left 10th rib", and consists of a 10.3 x 1.2 x 0.6 cm. rib with attached scant fragments of fibrous tissue. A representative portion is submitted following decalcification.
Part 2 is labeled "left renal mass and adrenal gland inside of bag sterile", and consists of an 890 gram left kidney and attached perirenal adipose. The kidney itself is 12.6 x 7.1 x 5.0 cm. Occupying most of the upper pole is a 6.5 x 4.8 x 3.0 cm. orange-tan, variegated mass with multiple satellite noduleswhich grossly extends to the renal capsule at the superior pole, where the perirenal adipose tissue appears firmly fixed to the capsule of the kidney. The tumor grossly extends into the renal vein, and approaches within 0.3 cm. of the vascular resection margin. However, all margins appear grossly free of tumor. The closest that the tumor approaches to the perirenal adipose tissue margin of resection is at the superior pole, where it approaches to within 2.0 cm. There is separation of the kidney from its fibrous capsule by a hematoma along most of its surface, except at the superior pole where the perirenal adipose tissue is firmly adherent. Additionally received is a 9.0 x 8.0 x 3.0 cm. aggregate of yellow, lobulated, adipose tissue containing a 5.5 x 2.5 x 0.8 cm. golden yellow, orange adrenal gland with subcortical hemorrhage. Portions of the tumor are taken for PCI, tissue is frozen in OCT and bulk, tissue is set aside for DNA studies, a small sample is saved for possible electron microscopy and the gross specimen is imaged in the digital imaging system.
Part 3 is received unfixed and sterile labeled "periaortic lymph nodes, for PCI (inside kept sterile for PCI)", and consist of two grossly recognizable lymph nodes, each approximately 1.5 cm. in greatest dimension. Portions of each of these lymph nodes are taken sterile and submitted to the Pittsburgh Cancer Institute, and the entire remainder of the specimen is totally submitted.
Microscopic Description